One of the many challenges of being a doctor lies in the large multitude of diseases whose progress we are powerless to cure, along with the inevitable senescence of all life with time. It is especially in these settings the physician must assume the vital role of “accompagner”,  the French word for one who escorts and keeps company with the person under their care. While death remains inevitable, it need not occur in a setting of loneliness, isolation. The physician poet invites us to join this dying patient and her husband in imagining what is to come and what it might mean. The key is being present for the journey, and for the aftermath for the survivor. It’s never an easy task, but remains one of the most rewarding for those of us who have taken on this role.


I wonder if the dead remember us, like we remember them.

Scared of ghosts as a child, I see how

adults crave their company. How easily fear

in the right hands, can be molded lovingly into longing.

I wonder what is like to die at home. Hospice,

a hope to be comfortable, comforted by

the companionship of a faithful lapdog, warmth

of a familiar blanket patterned with lingonberries.

For the husband who asked if I knew his wife

was a painter, I don’t know

if the end result is art or memory. After the visit,

I wonder if you will consider yourself

lucky to be haunted by the soft music

of brush strokes against canvas, when

the blanket is folded away, when the dog lingers

in the place where the bed used to be.

  • Matthew Lin, MD
Posted in America, Death and Dying, Family, Grief, Happiness, Health and wellness, Hope, Loneliness, Love, Marriage, Medicine, Poetry, Relatioships, Thoughts & Musings | Leave a comment


Wonderful imagery!

Anonymously Hal

My pain has always been 
prettier on paper...  

The way my tears land  
and make the ink bleed 
through the faded blue lines... 

The way my frustration 
smears the page into blurs of 
illegible letters and marbled designs... 

The way my notebook's 
corners are curled during 
the hours of countless sighs... 

And the way my fingers 
twist my misery...  

So that it's prettier 
than what's inside.   

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Human Sea

I’ve always been fascinated by the mysteries of human interactions, and how we have evolved as a tribal society. Today, many suffer from the separation from a community, a sense of not belonging to something bigger than themselves. Consciously or subconsciously, many seek to be reunited with that from which they have been separated. Hope you enjoy this poem.

Human Sea

The fabric of a group

is so delicate

The flow of its conversation

has a magic, mysterious way of

moving from level

to level

Listen to a group by sound

not words

it’s like the sea

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The Long Night of the Soul

One of the privileges of being a physician is being included in the often remarkable stories of people facing sudden reversals of fortune, and the courage, need I say grace, of the human spirit in dealing with the vicissitudes of life. The other gift I never foresaw in choosing my profession is the constant reminder of the importance of living in the moment, and never taking the generous bounty of life for granted. Here is a story of a man told in his own words facing fear, confronting mortality, and turning to faith. I hope it brings inspiration to your life as it did to mine.

The Long Night of the Soul

By Jonathan Tjarks 

I was almost relieved when the doctor said “cancer.”

It was mid-April and I had been sick for more than a month. Fevers every night. Sweating through my pillows and sheets. Fatigue so bad that I could barely get out of bed. Severe back and muscle pain. Dehydration. Weight loss.

The doctors couldn’t figure it out. It didn’t fit any normal pattern of symptoms. Their first thought was that it had something to do with my having had COVID-19 the month before. They called it “post-COVID syndrome,” an umbrella term to cover people who hadn’t fully recovered and still had symptoms. But it was a diagnosis of exclusion, meaning they had to rule out every other possible explanation first. Basically, if they couldn’t find anything else, then maybe it was this. It was the medical equivalent of a shrug.

I needed an answer. Cancer was one. I had been to the hospital three times in four weeks, and I was getting worse each time. Now there were treatment plans. Chemotherapy. Radiation. The doctors would at least know what to do.

I held my wife’s hand as the doctor went over the next steps. It was all a blur. I just couldn’t get one thought out of my head. I could actually die. Cancer might not kill me, but it could.

It was the one thing that hadn’t entered my mind on previous trips to the hospital. No matter how sick I was, I never doubted that I would eventually get better. I remember one conversation with a coworker, during which I listed all my symptoms, realized how bad they sounded aloud, and interjected to say that I wasn’t dying. I would be fine.

But at the hospital, for the first time I realized that maybe I wouldn’t.

I had never really thought about death before. I’m 33. I’m married and have a 1-year-old son. My whole life is supposed to be in front of me. I obviously knew I would die at some point. But that point, whenever it might be, seemed so far away that it might as well not have existed.

There was no reason for me to believe otherwise. I don’t live in a neighborhood with much crime. I don’t have a dangerous job. My days of staying out late and drinking are long gone. I’m in bed by 10 p.m. most nights. I don’t have any chronic illnesses. When I got COVID-19, it was the first time I had been really sick in my adult life.

And then I was diagnosed with cancer.

That was only the start of the bad news. The reason my cancer was so difficult to diagnose was that I had a sarcoma, a rare kind of tumor usually found in children and teenagers. Sarcomas account for only 1 percent of new cancer cases in the U.S. each year. They are most easily treated when they are still isolated in one spot. My tumors had spread through my bones, into my femur, hips, ribs, spine, and skull. There were too many to count. The medical report said they were “innumerable.”

The doctors narrowed the diagnosis to two types of cancer—Ewing’s sarcoma and osteosarcoma. They told us not to Google them. That they were so rare in adults that the statistics couldn’t tell us much about my situation. The sample size was too small. But telling someone not to Google their illness is like telling them not to look at a car accident as they drive past it.

The five-year survival rate for people with osteosarcoma whose tumors had spread to distant parts of their bodies is 27 percent. The same number for people with Ewing’s is 39 percent.

It wasn’t just that I could die. It’s that I probably would.

In my head, I had this idea that once I got to be about 70 years old, I would be ready to die. That was how old my dad was when he died. All my grandparents died in their 70s. I would be retired by then. Done raising my kids. And then I would be ready for whatever was next.

But then I thought about the people I knew in their 70s. My mom is 72. All four of my wife’s grandparents are in their 80s. One of her grandfathers still skis every year. I have never talked to him about it, but he certainly doesn’t seem ready to die. He’s probably like me before I was diagnosed. He knows it will happen at some point in the future, but does his best to block out the inevitable reality.

That coping mechanism doesn’t change, no matter your age. The thought of death is so painful that many people do everything they can to put it out of their minds. It’s easy enough in our society. I’m not surrounded by death. It usually happens far away, in hospitals and nursing homes and hospice centers.

One of the best metaphors I’ve heard for modern life is that it’s a car headed toward a cliff’s edge while billboards line both sides of the road, blocking the driver’s view. Those billboards are all the distractions that society has to offer. Netflix. Sports. Movies. Music. Everything you consume to avoid thinking about where you are ultimately headed. And those billboards cover your view until the end of the road, when suddenly the cliff approaches. Then, as your car is flying in the air, that’s when you start thinking about death and the meaning of life.

As a Christian, I felt like I was prepared for that moment. But there’s nothing that can truly do that. It’s the long night of the soul. It’s a version of a well-known phrase that I often think of. I don’t care how strong your faith is. Staring into the abyss will make you question everything. I wish getting through it were as simple as quoting a few Bible verses and then going to bed.

I don’t even think Jesus was ready. That’s the first thing I noticed when I read the Gospels after my diagnosis.

This was the scene after the Last Supper, when Jesus knows that Judas will betray him that night:

They went to a place called Gethsemane, and Jesus said to his disciples, “Sit here while I pray.” He took Peter, James, and John along with him, and he began to be deeply distressed and troubled. “My soul is overwhelmed with sorrow to the point of death,” he said to them. “Stay here and keep watch.” —Mark 14:32-34

Jesus normally left his disciples at night to pray by himself. But not that night. It was the only time he ever questioned God:

Going a little farther, he fell to the ground and prayed that if possible the hour might pass from him. “Abba, Father,” he said, “everything is possible for you. Take this cup from me.” —Mark 14:35-36

The most likely interpretation, to me, is that Jesus had known for a long time that he would have to go to the cross. It was always going to happen. He still had to do his ministry first. He still had to go to Jerusalem. He still had to have the Last Supper. But then, all of a sudden, there were no other things to do. The cliff’s edge was there. And he was terrified, just like anyone else would be. He might have thought that he would be ready to die. It’s easy to tell yourself when that point is still far away.

It’s different when it’s right in front of you. You think about your life. About all the things you still want to do. About the people you could be leaving behind. And you ask why. You ask why a lot.

There are many kinds of crying. The kind you do when you are by yourself in a cold hospital room, unable to fall asleep and telling God that you don’t want to die, is as ugly as it gets.

Most Americans spend so much time striving, trying to be successful, trying to climb further up the ladder. Trying to achieve. Trying to give our lives meaning. It all fades away in that moment, when all you are left to grapple with is what you really believe about life and death.

It doesn’t matter who you are, or what you have done, or how much medical care your money can buy. We all have to face that moment. It’s the only moment when every person on Earth is truly equal. We come into this world with nothing and leave it the same way.

A lot of those long nights of the soul have happened for me at the T. Boone Pickens Cancer Hospital in Dallas. Pickens started as an oil-and-gas man and became a billionaire business tycoon. He’s best known nationally for being the booster who spent so much money that he turned Oklahoma State football into a powerhouse. You can’t go anywhere in Dallas without seeing his name. I used to play basketball at the T. Boone Pickens YMCA, and I would drive by the T. Boone Pickens Hospice & Palliative Care Center on my way to work. He passed away in 2019, and it’s hard not to see his giving as a way to cheat death. Maybe he wouldn’t be around in the future, but his name would be. It’s the same reason U.S. presidents build libraries to celebrate their legacies, and we carve their faces into mountains.

I just don’t know how much any of that means to T. Boone now, wherever he is.

Many people don’t believe that he’s anywhere. That this life is all there is. Maybe they are right. But that doesn’t bring any comfort in the long night of the soul.

So what does?

I go back to that last night in Gethsemane. The last thing Jesus says to God is “Yet not what I will, but you will.” (Mark 14:36.)

He gives up control.

The reality is that none of us ever had any control of our lives in the first place. I had no control over getting cancer. It just happened. Nor do I have any control over how the months of chemotherapy will go.

It reminds me of something else Jesus said: “Can any one of you by worrying add a single hour to your life?” (Matthew 6:27.)

Worrying about death does me nothing. All I can do is believe and have faith that there’s some point to all this. That God is watching after me and my family, even if it doesn’t seem like it sometimes.

The latest diagnosis is that I have a BCOR-CCNB3 sarcoma, a type so rare that my oncologist, a sarcoma expert, had never heard of it. It’s in the family of Ewing’s-like sarcomas, but it’s not Ewing’s. It was discovered only in the past decade. Both my doctors and I are flying blind.

I don’t know when the long night of the soul will come for me again. I just know that I will turn to my faith in that moment. It won’t let you face death without fear. But it’s the only thing I’ve found that helps.

Postscript: Jonathan Tjarks wrote this moving piece in 2021. He was a sportswriter covering the NBA. His life ended in September last year before he reached the age of 35. He left behind a wife and young son. He also gave us this reminder to remove our own blinkers so we may see what is truly important in this journey we call life.

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How many of you have experienced the judgment of a snooty waiter or sommelier in a fancy restaurant? They seem to have a talent for wordlessly putting you down. Of course, this only occurs if you buy into their fantasy that their opinion of you actually matters. The following poem lays out the dynamic brilliantly.


She named a likely brand of wine
And thought she heard the waiter sniff
As though detecting from her mind
Some unpleasant malodorous whiff And when she pronounced the appetizer
The waiter’s eyelid started twitching
She swore he bared at least one incisor
As he slid resignedly into the kitchen Their salads flowed like rapids down
Waiter to the side, observing
Frozen horizontal frown
Blankly reliving something disturbing Then she the steak, her husband fish
And the tendons in the waiter’s neck
Some protocol or choice of dish
Blithely, blindly incorrect A flashy dessert and a cup of joe
He said “Of course” and turned a heel
But his subtle tone had let them know
How thoroughly they had failed the meal

Copyright © 2010 by Dave Grossman

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Tinnitus is a not uncommon hearing disorder I learned about in medical school. I hadn’t thought much about it until recently when my spouse developed the problem on an increasingly regular basis. After dragging her to one of my ENT colleagues, we were relieved to learn that she didn’t have a rare tumor called acoustic neuroma or any other brain dysfunction. That was the good news. The bad news is that despite the number of sufferers and multiplicity of attempted treatments, none have been found to be uniformly successful. It remains to this day an annoyance to be tolerated.

Poetry has long drawn on the noisiness of the human body to make music from language. The poet does an admirable job of underscoring the poetry-music connection both in the structure of the work as well as in its musical references. Hope you enjoy it.


Occasionally it sounds like

a cathedral tower full of bells

but usually it’s more like the last

scatter if cicadas at the end of summer,

an almost pleasant buzz and whirr,

thought with a slightly higher pitch,

as at night once the light has gone

and daytime noise has faded.

Crescendos rise then fall

in soft waves and reverberate

like keening voices

in Ligeti’s Lux Aeterna

lift and drop, pierce

and penetrate, throb

and smooth and finally

come to rest.

  • Gregory Luce
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Spiritual Essays #113

I found this essay thought provoking. Hope you do the same.

Kelly's Quest

How To Escape From Self-Fulfilling Prophecies and Limiting Patterns?

by Jayaram V

Have you ever wondered what could be the most important cause of all your problems? Why do certain things greatly concern you or bother you while you may not care for other things? Why are you excessively attracted to some objects and people in your life while you may not feel the same towards others? Some people spend their lives defending or working for a cause which to others may look a mere waste of time.

Many people worship wealth and pursue materialistic goals as if having status and recognition in society is more important than anything else. In contrast you may come across people who go to the most difficult and dangerous places in the world to work for the poor and the helpless. What motivates an ascetic person go the Himalayas or a village boy become…

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The Speed of Time

In many ways, life is like a roll of toilet paper. The closer you get to the end, the faster it goes. For those of you who make comments about how fast time is passing, the following poem is for you.

The Speed of Time

The speed of time is not a constant sort of an expression
It seems to be experiencing vast acceleration
The more of it that races by, the quicker its progression
Foot upon the gas without apparent destination
Perhaps because we live in an expanding universe
Or the weight of the past is piling up and causing an imbalance
Perhaps it’s the result of some revengeful gypsy curse
Or just another Homo sapiens odd perceptual talent
It took molasses time for humankind to struggle past
The days of caves and cobblestones and myths of manticores
And now the rate of change has gotten throttled up so fast
That they’re already selling DVDs in antique stores
An exponentially careening flitting fleeting flirt
I frankly am afraid that someone’s going to be hurt

Copyright © 2010 by Dave Grossman

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The Gift of Books

I’ve had a long love affair with books and reading. Not only have I learned most of what I now know from inside their pages, but books have enlarged my vision of the world, created possibilities for my life I never knew existed, provided endless hours of entertainment, and brought me in contact with others who appreciate the magic a good writer is able to weave for a reader. I recently rediscovered the vast (and under-utilized) treasures available in my local public library, and encourage you to do the same.

I just read a wonderful book by Gabrielle Zevin, The Storied Life of A.J. Fikry. (They made a movie out of it, but the book is infinitely better.) It’s a love story, a mystery, a story of flawed people who find ways of surmounting their limitations, and a paean to great books and small book stores along with their ever present challenges. It’s a reaffirmation of the potential for good that exists in the most ordinary of us, and the opportunity to discover titles worthy of your time. Along with similar works such as The Paris Library and The Little Paris Bookshop, it reveals the power that a book can have on changing a life.

Given the growing power of Amazon in the publishing world and the decline of brick and mortar stores, even the prior giant Barnes & Noble, I was delighted to read that Barnes & Noble has recently managed to create a turnaround in its fortunes after being taken over by the hedge fund Elliott Management. In 2019, new CEO James Daunt decided that the business of book stores is to sell books and not unrelated products like batteries or water, and that allowing each store to organize inventories to appeal to its local customers so they can come in and browse, creates a competitive advantage over online outlets. Who knew? Maybe there is hope that those who are not hopelessly lost to television and social media can keep the light of knowledge and the magic of discovery alive longer by discovering the treasures found within the pages of a good book.

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How Was Clinic?

We humans tell stories in our attempt to make sense of our lives. Some stories are told directly, while others have their meanings concealed behind the words that we use. I love this poem, as it resonates in harmony with my own experience of life.

How Was Clinic?

They reminded me of your parents

but better dressed, my wife Jessica said

as she described a patient and her husband

she has seen in the clinic that day – a patient

with metastatic breast cancer on her way to hospice

but still asking Jessica about her life and family –

by which she meant, I think,

that they must have been wearing something

more dignified than 20-year-old-hand-me-down

skateboarding T-shirts from their son,

by which she meant, I think,

that they valued quality of life over quantity,

having seen what happened to their own parents

as they lived into the nineties,

by which she meant, I think,

that they were vulnerable in the same way

my parents were becoming vulnerable,

by which she meant, I think,

that she loved my parents

even though she was embarrassed they wore

faded Green Day shirts to fancy restaurants,

by which she meant, I think,

that she would be there for them

as they welcomed their end,

and for me.

  • Matthew J. Farrell
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